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A COVID-19 Timeline

Before we jump in, there is one caveat, the medical data surrounding Covid-19, is in flux because we lack standardization of information globally. After all, our data sources are still busy treating patients and not cleaning up messy data, and because there are variables that we need even to identify.

Transmission

We do know that Covid-19 is transferred from an infected individual to a susceptible one by direct person-to-person contact or indirectly through viral particles shed by the infected into the intimate environment. Those transmissions can occur in “the household, workplace, school or randomly in the community,” and that is part of the rationale behind social distancing. The halo of transmission extends, we believe, for about six feet around an...
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Tracking COVID-19

More specifically, the researchers looked at two states within southern India with the where-with-all in terms of healthcare workers and spending to mount an aggressive surveillance program – testing all that sought care for respiratory or flu-like symptoms, creating containment zones of 5 km around homes for daily surveillance for individuals with new symptoms, and daily follow-up of the contacts of confirmed cases 5-14 days after their contact.

From a dataset of over 3 million known exposed contacts, the researchers looked at 575,000 contacts with sufficient demographic and laboratory information after exposure to 85,000 confirmed, “index” cases. [1] The confirmed cases were slightly younger and female than the general population in these states, suggesting that the contact...
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Tracking COVID-19

One of the newer ones, at least for me, is the NY Times Upshot Corona tracker, which can be found here.

Just a few suggestions. Skip looking at the cumulative data, while they give you a sense of the scale, they do not tell you whether things are getting better or worse. For that, you need to look at the daily growth charts – the ones that are showing the rate of change. Flattening the curve requires the rate of change to go to zero and then hopefully negative. 

COVID-19 deaths occur 5 to 14 days after diagnosis and hospitalization, they are a lagging indicator, so keep that in mind. The number of new cases will peak before the deaths. Finally, look at the new cases per...
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India and COVID-19

 

 

 

It took just my first MBA course on health systems to realize how provincial was my vantage point for all of my cosmopolitan ways. So before we explain away the differences in these statistics as just shoddy reporting, let us suspend our pre-judgments.

COVID-19 in India

https://www.worldometers.info/coronavirus/country/india/

As you can see, daily new cases are down and by a lot. With a peak in September of 100,000 a day, it is now 10-fold lower. And here is a comparison with the US, from Johns Hopkins

...
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Ellume’s At-Home COVID-19 Test, Updated Technology for the COVID-19 Age

For those in a rush, the technology has been around for quite some time. The test is not as accurate as a PCR test, especially among the asymptomatic, and it differs from other at-home tests being available without a prescription.

How does it work?

The technology, known as lateral flow immunoassay, is not new. It is the basis of the ubiquitous pregnancy tests that tell you yes or no.

A sample is taken using a cotton swab from your nose, and it is placed in a dropper containing a fluid to allow the particles within the sample to migrate through the test medium. The viral particles from your nose are then bound to a fluorophore – a chemical that can fluoresce, light up. This chemical mix is now put into the testing system that uses capillary action...
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Rethinking COVID-19 Mortality Statistics

“Statistics may be used to convert complicated social problems into more easily understood estimates, percentages and rates.” Joel Best [1]

Introduction

The science of collecting and analyzing numerical data is fundamental to understanding social phenomena. In the Coronavirus Era, researchers, physicians, administrators, and funding agencies aim to seek a consensus about the origins, pathogenic effects, effective treatments, and containment measures regarding a novel coronavirus – all of which require data predicated on morbidity and mortality statistics. Careful attention to the data is critical for understanding mortality figures while remaining mindful of the flaws and limitations...
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COVID-19 and Cancer Care

The health system wants you back and rather than dwell on cash flow and other financial vagaries, the discussion is all about how the COVID-19 instituted delays, may further harm your general well-being

"For patients with cancer, delay of surgery has the real potential to increase the likelihood of metastatic disease, with some patients' tumours progressing from being curable (with near normal life expectancy) to non-curable (with limited life expectancy)." 

With that opening, consider this paper, Collateral Damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic. From the title and that opening statement, I anticipated a lot of collateral damage – spoiler alert, as with everything...
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Health Care Workers & COVID-19

Health care personnel (HCP) are defined as

“…all paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances (e.g., blood, tissue, and specific body fluids); contaminated medical supplies, devices, and equipment; contaminated environmental surfaces; or contaminated air.”

That is a lot of individuals and includes many without direct patient contact; you only need to be working in that potentially contaminated environment. Let’s start with a few limitations in our data collection, a key finding in a...
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COVID-19 Testing & Subsequent Care

As with most viral infections, the standard treatment, and this applies to roughly 80% of Covid-19 cases in the aggregate population, is rest, hydration, and symptomatic relief, i.e., antipyretics – medications to reduce fever and antitussives – medications to reduce coughing. But knowing your Covid-19 status means that you can be appropriately quarantined and treated in your home or hospital.

In a world of limited resources, and that is the current case with Covid-19 testing, more plentiful tests for seasonal flu and bacterial sources of infections are employed to screen out these causes and concentrate Covid-19 testing on more likely individuals. The data so far indicate that as with all testing, there is a percentage of false negatives, meaning the test shows no evidence of...
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Treating COVID-19 with Radiotherapy

The trials

Consider first, a Phase I/II trial being conducted at Emory [1]. Let me remind you that these trials are meant to look at safety, not efficacy. The researchers identified nine possible candidates, but to give you a sense of how critically ill these patients were, four died before treatment could be initiated. All patients had COVID-19 based upon nasopharyngeal swabs, none had any other COVID-directed drug therapy the day before or for three days following treatment, and all were clinically deteriorating. Five patients underwent low-dose pulmonary irradiation. All were elderly, with significant co-morbidities, requiring supplemental oxygen, all demonstrating changes in their mentation; four were African-American, one Caucasian. Certainly not a random...
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